Therapeutic communication is a practice in which the nurse assists a patient to an improved understanding through verbal or nonverbal interaction (Mosby’s Medical Dictionary, 2009). According to Russell Delucas 2010, therapeutic communication is a type of psychotherapy that uses verbal and nonverbal skills. It is an interpersonal relationship between the nurse and the patient throughout, which the nurse centres on the patient’s specific needs and to uphold an effectual swap of information (Videbeck 2010, p.99).
I will explore how the skill of therapeutic communication is important to the nursing practise in the healthcare environment. The benefits of applying therapeutic communication will be covered, along with the effects of not using therapeutic communication exploring key issues such as verbal and non-verbal communication, questions and listening and empathy.
Furthermore, I will explore patient diversity focusing on areas of diversity and culture.
Also, I will discuss some key relevant aspects of The Nursing and Midwifery Council Code (NMC) (2015) focusing on Prioritising People and the impact on therapeutic communication.
Finally, a conclusion on this discussion summarising how the skill of therapeutic communication is relevant to present-day nursing practice will be drawn together.
Benefits of using Therapeutic Communications
Peplau depicts nursing as a vital therapeutic relational process; by utilizing viable communication skills the nurse can set up and keep up a helping nurse client relationship. Peplau’s hypothesis depends on the standards of individual’s relationships. It recommends the improvement of interaction between the patient and the nurse to upgrade the patient’s commitment in his/her treatment. This can be valuable to nursing practice by reviewing the patient’s needs through therapeutic communication and working with his/her to discover arrangements that plan for the emergency.
The benefits of effective communication in nursing have been researched for many years by Dougherty and Lister (2007), Kihlgren et al (2003), Boore (1978) and Hayward (1975) and all argue that the way in which a nurse interacts and communicates with their patients can have an impact on recovery time and can also greatly affect the patient’s experience and the standard of care given
It has also been argued that Therapeutic communication is a crucial tool above all other interventions in such areas as mental health setting to allow for optimistic results, building of nurse client relationship, ventilation of sentiments, for exploring fundamental approach of patients about themselves and their illnesses (Morrissey & Callaghan, 2011).
Effects of not using Therapeutic Communications
In contrast when carried out ineffectively therapeutic communication has been shown to be the leading cause of inadvertent patient harm and clinical errors (Leonard et al, 2004, P85-90, Pincock, 2004, P1136, Gardezi et al, 2009, P1390-1391, Sutclifee et al, 2004, P186-194, Ghandi, 2005, P353-358). In the Every Complaint Matters (2008-2009) report produced by The Parliamentary and Health Service ombudsman it is stated that a large percentage of complaints against the NHS are a result of communication breakdown between healthcare professional and patients. Chant et al (2002, P12-21) suggests that one of the most fundamental barriers to effective communication in practice is the clinical environments policies and practices. This is supported by a qualitative study of patient experiences by McCabe (2004, P41-49) which stated that patients felt that ‘nurses were often to task orientated’ and only approached patients to carry out administrative or functional tasks. Chant et al (2002, P12-21) also writes that students often steered away from chatting with patients through fear of appearing lazy and not looking busy.
It has also been argued that Non-therapeutic communication converses that patient’s dignity and care is not our priority that make the patient feel disregarded and not the valuable person (Morrissey & Callaghan, 2011)
The evidence suggests that therapeutic communication is sometimes forgotten could be because most nurses (86%) came forward and stated that multiple care activities had been left not finished because of lack of time on their last shift also the comforting or talking with service users (66%) came out as the most unfinished task in a nurses day (Jane E Ball, Trevor Murrells, Anne Marie Rafferty, Elizabeth Morrow, Peter Griffiths 2013).
Whilst patient care is primarily associated with medical treatments and procedures, it is important to recognise that the relationships formed between patients and nurses significantly influence patient wellbeing. In a study conducted (Street, Makoul, Arora and Epsteine 2009), it was shown that the communication between patients and nurses has a direct impact on patient health and moreover, has the potential to benefit or worsen their condition.
Key areas to Therapeutic Communications
Verbal communication relates to the spoken word and can be conducted face-to-face or over the telephone (Docherty &McCallum 2009). Nurses continually communicate with patients; verbal communication allows the nurse opportunity to give information to the patient about their care or treatment, to reassure the patient and to listen and respond to any concerns the patient may have (NMC 2008). Effective communication is beneficial to the patient in terms of their satisfaction and understanding of care and treatment they have been given (Arnold & Boggs 2007), while at the same time optimising the outcomes or care and/or treatment for the patient (Kennedy- Sheldon 2009).
Some of the key areas in verbal communications relate to non-judging language, not quick to problem solve, invites interaction by offering open questions, values the other by being reflective, honesty and tone of voice (Stickley, Freshwater 2006).